I'm an American expat currently living in Turin, Italy. The headlines about COVID-19's spread in Italy are pretty scary. I put this notebook together so family, friends, and curious people can get a little insight into what's actually happening.
The first section offers a statistical overview. I'll update this every day. The second section has some of my anecdotal observations and tracks a few headlines. The third section has a little bit more on the importance of evidence-based storytelling.
Overview of the Problem
I'm pulling data from Italy's Civil Protection Department. I think they are doing a great job of providing the public with accurate information. Here are the latest figures from Piedmont. The total cases are the total number of diagnosed cases of COVID-19 in the region.
Turin is the regional seat of Piedmont. It's a quirky city of modest size situated at the foot of he Alps. The city hosts about 875,000 residents while an additional 3 million people live in the surrounding region of Piedmont.
Here are the total number of COVID cases in Piedmont starting from February 24th. Rollover the bars for more detailed information.
name='Total Cases in Piedmont (Turin)', marker_color=piemonte_color)
It's hard to understand the scope of the problem in any Italian province without comparing it against the epicenter of the original outbreak, Lombardy. Lombardy is just east of Piedmont. Both Lombardy and its capital Milan are much more populous regions. Here is the comparative growth of the virus in raw numbers.
Looking at the data on a logarithmic scale makes it easier to see the relative change over time. The important takeaway is the shape of each slope. I'm particularly interested in the slope's change after March 8th, the date of the original ban on regional movement, as compared to the slope after October 7th, the first significant governmental restriction from Rome in many months. Both dates are indicated by a red dot.
A slowing of the growth rates outside of Lombardy gave credibility to Prime Minister Giuseppe Conte's decision to order the original lockdown.
Testing is an important part of containing the virus' transmission. Roughly a quarter of Piedmont's residents have been tested by the start of the second wave. Better vigilance will hopefully help curb the infection rate faster.
mode='lines', name='Total Cases in Piedmont (Turin)',
mode='lines', name='Total Tested in Piedmont (Turin)',
mode='lines', name='Total Deaths in Piedmont (Turin)',
Turin slid back into the red zone several days ago as Europe struggles to secure and disseminate the vaccine to its population. The AstraZeneca vaccine has been pulled in many markets, a move that reflects an abundance (over-abundance?) of caution, and subsequently re-instated.
There is much to be said about the US/UK's handling of the virus. But they both seem to be in a better place than Italy today. These two countries also seem to have benefited from the EU's vaccine manufacturing:
Even US has received vaccine exports from EU: 1 million in February, and 3.9 million doses of Johnson & Johnson a few weeks ago according to the New York Times. J&J doses made in US can't go to EU. Overall it appears EU has exported half the doses made here.
The vaccine has turned this global phenomenon into a geopolitical game. I started this blog to cover the impact of COVID-19 on Turin and our surrounding area; our region was overshadowed by the more dramatic events happening in neighboring Lombardy. My writing covered small events in my life and regional events and trends.
Geopolitical concerns and fights over vaccine distribution are outside the scope of this blog. The present moment seems like a good time to retire 🇮🇹 The Corona Virus in Turin, Italy. I'm happy to have a local record of the last tumultuous year, written from the unique perspective of an American ex-pat.
Thanks to the roughly 20,000 people who read this effort. I hope you found reading the blog as informative as I did writing the blog. And if you're in Turin, please do drop me a line at firstname.lastname@example.org. We'll grab a coffee.
In brighter news, Castello di Rivoli, a large contemporary art museum in Turin, is becoming a vaccination site. Apollo reports that certain exhibition spaces will be open to those getting vaccination. Including this mural by Claudia Comte:
I sadly haven't been able to travel to the United states for about a year. Looks like the country is putting a new set of COVID enforcement measures at the border.
Effective January 26, all airline passengers to the United States ages two years and older must provide either a negative COVID-19 viral test taken within three calendar days of travel or provide a positive test result and documentation from a licensed health care provider or public health official of having recovered from COVID-19 in the 90 days preceding travel. Passengers must also attest, under penalty of law, to having received a negative qualifying test result or to recovery from COVID-19 and medical clearance to travel.
Visitors have dropped by over 70% at Turin's Egyptian Museum during 185 open days as the museum was closed for 180 days due to the coronavirus epidemic, the institution said on Wednesday. However, online activity has increased significantly with nearly 568,000 new users on the website and growth on social media - up 38% on Instagram and 1,345 on Youtube, the museum added.
Turin is almost entirely open today, which feels very unusual. It represents a temporary reprieve from the new new normal, which we're all about to face once again.
December 24, 2020 to January 6, 2021: a curfew will be in place from 10:00pm to 5:00am. There are specific exceptions on specific days (December 28, 29 & 30 and January 4) but the differences are quite nuanced.
All flights from the United Kingdom are banned until January 6, 2021
Italy overtook the UK and now has Europe’s worst virus death toll:
University of Turin Epidemiology and Medical Statistics Professor Lorenzo Richiardi told La Stampa daily on December 4:
The reasons for the high death toll remain a mystery. [...] One theory is that it is because we have an elderly population, but that is not enough.
The New York Times ran a retrospective on what happened in Northern Italy in the critical early days of the first wave.
I wrote about Patient 0 much earlier this year (see the entry Patient 0/200). Very little new information has come to light since then.
Throughout flu season, some local family doctors in the Lombardy region had noticed strange pneumonia cases and were prescribing more scans than usual. The region has business ties to China, and local infectious disease doctors had kept an eye on the coronavirus outbreak in the city of Wuhan. They also trusted Italy’s new and narrower protocols, adopted from the W.H.O. at the end of January, which essentially limited testing to people linked to China. Then, on Feb. 20, Annalisa Malara, a doctor in the town of Codogno, in Lodi province, decided to break the protocol and test a 38-year-old man with serious pneumonia who was not responding to standard treatments. The man’s test came back positive that same evening and he became Italy’s first known locally transmitted case of Covid-19.
Much of the article focuses on Bergamo, where a friend of mine caught the disease. He did not know it at the time, but avoided seeing his parents due to an abundance of caution. It is a good thing he did. His parents remain in good health.
Italy's daily deaths more than 30% of spring peak, which is a far better statistic than most European countries. We are currently in a softer lockdown, and as this notebook demonstrates, the results are encouraging. But that is about to change as restrictions will again relax for the holiday season. Professor Sridhar of Edinburgh University from the above article:
Unless we see massive behavioral change, we are going to see January and February lockdowns. [...] The virus doesn’t care it’s Christmas.
I'm happy that the sacrifices made by the many individuals who are following the ordinances are beginning to show their value. Calabria, Lombardy,and Piedmont are downgraded from red zones to orange zones; regions of Liguria and Sicily are downgrading from orange zones to yellow zones. This ordinance will run from 29/November - 3/December.
Unfortunately, orange zone restrictions are still pretty severe:
Curfew from 10 p.m. to 5 a.m.
Bars and restaurants will stay closed 7 days a week, while take-away is allowed until 10 p.m.
shopping centres will be closed on weekends
Museums will always be closed.
swimming pools, gyms, theatres, cinemas are closed.
International Travel in the Times of COVID
17/November (updated 20/November)
I am preparing to travel to the United States in the coming weeks. The route to and from the European Union is peppered with uncertainty and health risks. The Western world is spiking in cases and new restrictions are being announced weekly. Here is how I'm preparing for each leg of the trip.
First, I'm overdue for buying a comfortable washable/reusable mask. The 27/October entry in this notebook details the latest data on this type of mask. The packaging should display a CE mark or the validation of the Higher Institute of Health (often indicated as "EN 14683"). These masks will offer a filtering capacity (i.e. protection from others) of either 95% (type I) to 98% (type II).
The benefit of an additional layer of protection in the form of glasses remains unclear.
In one hospital in Suizhou, China, 276 patients were admitted over a 47 day period, but only 16 patients — less than 6 percent — had myopia or nearsightedness that required them to wear glasses for more than eight hours a day. By comparison, more than 30 percent of similarly aged people in the region needed glasses for nearsightedness, earlier research had shown.
The New York Times acknowledges that this is a compelling statement, but warns there are many vectors for uncertainty. The article concludes:
For the vast majority of people, that extra level of protection probably isn’t needed if a person is wearing a mask and keeping physical distance in public spaces.
🚎 🛫 Vanchiglia, Turin → Airport 🇮🇹 → Airport 🇺🇸
Readers of this notebook can clearly see that the COVID outbreak is currently quite bad in both Piedmont (Turin) and Lombardy (Milan) - the locations of my two main airports.
I was originally planning a direct flight from Malpensa (MXP) outside of Milan. But recent restrictions on inter-regional travel have made me consider a one-stop flight from Turin-Caselle Airport (TRN).
A two hour flight might also be safer than a two hour bus ride or a two hour train ride that transfers in the busy Milan central terminal. A study paid for by the International Air Transport Association (IATA), "Research Points to Low Risk for COVID-19 Transmission Inflight", finds that inflight COVID transmission is exceedingly rare. This is a pro-industry lobby, so the results should be read with a skeptical eye.
They compiled 44 cases out of 1.2 billion flying since the pandemic started. That's 1 case for every 27.3 million travelers
Even if 90% of infections were not counted, that would amount to 1 case for every 2.73 million travelers
The IATA study suggests four reasons for the low transmission rate.
Seats and passengers face forward meaning limited face-to-face interactions.
Seat backs act as a solid barrier.
Research to date suggests airflow exchange rates and direction are less conducive to droplet spread than other indoor environments, or modes of transport.
Modern jet airliners deliver high air flow and replacement rates, combined with hospital-grade HEPA filters. Cabin air is exchanged every 2-3 minutes
This correlates with the Center for Disease Control's (USA) own advice on flying:
Air travel requires spending time in security lines and airport terminals, which can bring you in close contact with other people and frequently touched surfaces. Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on airplanes. However, social distancing is difficult on crowded flights, and you may have to sit near others (within 6 feet), sometimes for hours. This may increase your risk for exposure to the virus that causes COVID-19.
The virus can spread on a flight - it's just rare. Here's a map of the virus transmission in 1st class from the London to Hanoi study:
Take the boarding process. Jet causeways can be packed, as people stack up waiting their turn -- only to enter a parked plane that likely has little to no air recirculation.
"During boarding that's when there's usually no ventilation -- the planes don't have their auxiliary power units going, they're not often tied into the gate-based ventilation systems," Allen said.
"We've done measurements on airplanes when people are boarding, and we see high levels of carbon dioxide, which is an indicator that there's insufficient ventilation," Allen said.
🚗 Airport 🇺🇸 → Central Illinois
Wherever I land, I plan to rent a car and drive down to Central Illinois to meet my parents. I will need to make sure I am tested and clear of the virus before I actually spend time with them. How this will work remains to be determined.
🛬 Airport 🇺🇸 → European Union 🇪🇺
I'm also concerned about returning to the European Union. I hold a residency permit, so I should have advantages over other Americans. But I find these travel bans a bit difficult to understand. They have many exceptions and it's always unclear how I fit into them.
With cases on the rise in the USA, it's possible that a new travel ban could be enforced. At the moment, the United States is currently grouped in List E of countries. The Italian Ministry offers an overview of what this means in English:
The DPCM of 24 October 2020 allows travellers from the Countries in List E to enter Italy if they have a proven and stable affective relationship (regardless of whether or not they cohabit) with Italian/EU/Schengen citizens or with persons who are legally resident in Italy (on a long-term basis) and if they are traveling to their partners' home/domicile/dwelling (in Italy). On entering Italy from any of these Countries, travelers will be required to fill in a self-declaration form specifying the reason for entering/returning to Italy. The form must then be presented to the competent authorities if requested. [...] Travellers will be allowed to reach their final destination in Italy only by private means (airport transit is allowed, however without leaving the dedicated areas of the terminal). Travelers must self-isolate and undergo supervision by the competent health authorities for 14 days.
On 7 October 2020, the Council of Ministers extended the nationwide state of emergency until 31 January 2021. The details will certainly change between now and the end of January.
An Associated Press analysis reveals that in 376 counties with the highest number of new cases per capita, the overwhelming majority — 93% of those counties — went for Trump, a rate above other less severely hit areas.
With the numbers surging, it's difficult for me to relate to those who believe the virus is under control. But that's what many voters believe:
Thirty-six percent of Trump voters described the pandemic as completely or mostly under control, and another 47% said it was somewhat under control.
Corriere della Sera's Milena Gabanelli does data-driven analysis for the Milan daily. Her work with Simona Ravizza looks at the standards set by the Istituto Superiore di Sanità (Italian National Institute of Health (ISS)) on masks. I'm particularly interested in washable/reusable masks.
To be certified by the ISS, these masks must meet 5 requirements (defined by the UNI EN 14683 standard): resistance to liquid splashes, breathability, bacterial filtration efficiency, microbial cleaning, and they cannot cause allergic reactions.
To meet the legally required levels of breathability, bacterial filtration efficiency, and microbial cleaning,
Washable masks must be washed every 8 hours at 30°C and able to withstand up to 20 washes (indicated by the manufacturer) before losing any of its effectiveness on the five dimensions above.
Washable masks with a pocket to insert a new activated carbon filter must abide by the same standards.
Look for the presence of the CE mark or the validation of the Higher Institute of Health on the packaging - the standard otherwise indicated as "EN 14683" on the packaging. These masks will offer a filtering capacity (i.e. protection from others) of either 95% (type I) to 98% (type II).
Protesters gathering in Turin's Piazza Castello were eventually dispersed by police firing tear gas into the crowd. The owners of small businesses seem especially aggrieved by the new restrictions.
Witnesses said a number of luxury stores, including a Gucci fashion shop, were ransacked in central Turin as police responded with volleys of tear gas as they tried to restore order in the city.
Italy faces yet another difficult choice. The numbers in Piedmont look to be rising faster than they did earlier in the year. I hope this is true, in part, because of the rising number of tests. Stay healthy everyone.
Nexa talks are generally given on campus at the Polytechnic University. Unfortunately, COVID also made this an impossibility. I gave the talk online instead. This at least provisioned a decent recording of the talk (embedded below). For an overview and a few details on the finer points, please see my blog.
A New Government Directive For the Second Wave
Cases are once again rising in Piedmont and throughout Italy. In response, the Council of Ministers extended the state of emergency to January 31, 2021. They also introduced an obligation to wear masks outdoors and indoors (essentially anywhere other than in private homes) and extended the Immuni App's period of use.
When landing in Italy from Belgium, France, the Netherlands, the United Kingdom, the Czech Republic and Spain, travelers must take one of two precautions:
Upon boarding, travelers must present to their carrier a certification that they have undergone a molecular or antigenic test and received a negative response within 72 hours prior to entering Italy.
Take a molecular or antigenic test, to be carried out by means of a swab, when arriving at the Italian airport or within 48 hours of landing.
Most outbreaks are still linked to the home, but there is a sharp increase in the number of new cases where no epidemiological link was found.
(An outbreak is the identification of 2 or more positive cases linked to each other.)
CNN reporters Barbie Latza Nadeau and Livia Borghese sing Italy's praise as a new wave of infections are reported in Europe.
It's still too early to draw any definitive conclusions about Italy's lockdown. I can attest that the magnitude of the state's actions could be felt viscerally throughout Turin. The CNN report captures how restrictions were gradually lifted:
In early May, the country gradually started to open up, first for takeout food, then table service. With each new taste of freedom, the health authorities checked the contagion rate, never allowing more establishments to open if there was a spike, and warning they would lock back down if things turned.
I'll never forget the first dinner I had after the most intense part of the lockdown was lifted. We walked to Hui Wei Xiang and ordered a couple Crêpes Cinesi (aka Jianbing 煎饼). There was no eating indoors, so we walked to the Po River and watched people walk by. Up to that point, citizens were only allowed outdoors for a narrow set of purposes - always near their home and never in a group. It was the first night any of us could walk outside with our friends and family. This was indeed the "taste of freedom."
The authors continue to opine:
In the US, lockdowns have been erratic, and in the UK, the reopening has been complex and hard for the population to understand. There are loopholes and exceptions to almost every rule. Even in Spain where the virus hit hard and the lockdown was rigid, the virus has managed to find a new footing, in part because authorities reopened too fully, too fast. You can go dancing in Spain, but not yet in Italy.
France, too, has seen a resurgence of the virus, but authorities there only instituted a mandatory face mask indoor rule on July 20. Italy has continued the requirement since the beginning and Speranza says they will likely stay for some time to come.
I'm hoping for the best in Italy's choice to stay the course. Not only for my own sake, but as a model for other democracies that are struggling to balance the rights of citizens, economic realities, and the overall health of the population.
It looks like Italy is getting a lot of support from their neighbors:
Italian Prime Minister Giuseppe Conte said that Italy was "satisfied" with the results of the plan, which would see 28% of the total funds, or €209 billion directed towards Italy. That figure includes €81 billion in grants and €127 billion in loans.
With many American states growing in COVID cases, the U.S. Embassy Rome, Italy has issued this statement:
As of July 1, the European Union (known as the EU, which includes Italy) began lifting the restrictions on non-essential travel into the EU for residents of certain third countries. This does not include United States residents, however the list will be reviewed every two weeks. Please visit https://reopen.europa.eu/en for more information.
We conclude that in this outbreak, droplet transmission was prompted by air-conditioned ventilation. The key factor for infection was the direction of the airflow.
How bad was the breakout in Italy? Out of nearly 10,000 Bergamo residents who had their blood tested between April 23 and June 3, 57% had antibodies, indicating they had come into contact with the virus and developed an immune response.
It’s been six weeks since Eleonora Furlan first asked about an 800,000-euro ($896,000) state-backed loan to save her business, but she still has no idea if she’ll get it. And her seven employees haven’t received any state relief since their temporary layoffs.
“I’m angry I’m not getting a clear answer; I have no Plan B,” said Furlan, the 42-year-old owner of Pregi Srl clothes wholesaler near Turin in northern Italy.
The loan program has delivered about 0.1% of the 400 billion euros it promised, according to a joint statement of the task force including the Bank of Italy and Treasury.
The Push For Open Access and Open Science in Italy
Access to valuable research is arbitrarily limited. Morriello, an expert in library science, illustrates the problem:
The acquisitions models imposed to libraries and library consortia have restrains in document delivery, walk-in users, number of downloads, and sometimes in simultaneous access to resources if this is the subscription model. In the current situation, in which all researchers are working from home for their regular academic activity and many are working at finding a cure for Covid-19, this is a big limitation.
Publishers responded by temporarily relaxing the rules. But not fully:
However, most publishers, either in Italy or internationally, just opened a selection of resources – and in some cases upon request – that they believe are useful to Covid-19 research, but they did not open all their publications to allow researchers to see and choose what can be really useful from the different scientific perspectives.
Morriello concludes that this needs to be a step towards a new normal of open access to information. But it will take sweeping changes to fundamental assumptions about copyright:
Researchers all over the world need to access data and knowledge quickly, as soon as it is produced, freely and without any limitation, in order to be able to defeat coronavirus. For this reason, AISA, an Italian Association for the promotion of Open Science, wrote a public letter to the President of the Italian Republic to ask for a serious and urgent national policy for open science, starting from rethinking research assessment and copyright laws.
Apple and Google decided to bake an automated exposure notification service into their portable devices. The software will enable intra-device information exchange over Bluetooth while keeping each individual’s identity a secret.
Turin's Nexa Institute, a leading internet research body, has called into question the effectiveness and raised privacy concerns created by contact tracing apps.
My bottom line: the Apple/Google technology will be the most widely available technology intended to curb disease transmission while maintaining citizen privacy. If we are going to automate contact tracing in the West, this is how it will happen.
In the northern region of Lombardy, which includes the financial capital Milan and has been most ravaged by the disease, deaths were up 186 per cent in March from 2015-2019. They increased by 47per cent in neighbouring Piedmont to the west.
Looking at individual cities, the worst-hit was Bergamo, near Milan, where deaths were up 568 per cent in March compared with the 2015-2019 average. The nearby cities of Cremona and Lodi saw increases of 391 per cent and 370 per cent respectively. In Milan they rose 93 per cent.
In Rome, Italy's most populous city, which has been relatively lightly hit by COVID-19, overall fatalities were down 9 per cent from the previous five years. The Sicilian capital Palermo also posted a 9 per cent decline.
4.5 million workers are set to return to work today. Al Jazeera takes special note of the Piedmont region:
Entrepreneurs in the north have been preparing to ready their business premises for the reopening, while some resumed operations last week after being granted formal permission.
"We had to reopen, we didn't have a choice. I closed the activity having plenty of orders," said the owner of one engineering factory who asked to remain anonymous. In Piedmont's Alessandria, home to his factory, the case rate is still growing by 13.7 percent on a weekly basis. "If those orders [aren't fulfilled by] me," the owner said, "my clients would go somewhere else."
Around 80 people are employed in the factory, which was fully sanitised before its reopening. All machines and equipment are cleaned thoroughly at the end of each shift. All health protocols and guidelines provided by the government, in addition to further safety measures, have been implemented.
FCA (Fiat Chrysler Automotive) this week resumed van production at its Atessa plant in central Italy and some operations in other Italian plants, including preparatory works [for reopening on 4/May] at its Melfi facility for the final development of Jeep's new hybrid cars, and at Turin's Mirafiori plant for its new electric 500 small car.
Author of Arte povera: notes for a guerrilla war (1967), and Turin resident, Germano Celant dies from the corona virus (aged 80). The Arte Povera (Poor Art) movement sought to undermine established institutions and values. Much of its influence emanated from Turin.
The movement eventually became an influence. From Celant's obituary in The Art Newspaper: collectors’ support for his "guerrillas" was quickly won, confirming the apparent paradox by which the wealthy love to surround themselves in effigy with their opposites. By 1989 he had become a senior curator at the Guggenheim in New York City, an institution supported by a mix of old money and corporate sponsorship.
Celant saw this compromise as part of his vision. In 1988 he told Il Giornale dell'Arte: “A museum is a place of consumption; it must engage its consumers, stimulate and seduce them, so that they come again and again. I realize that this seems crudely industrial, but the survival of museums depends on an active, not a passive, destiny tied to the concept of an academy for a select few. Today the discourse is international."
New Prime Minister’s Decree For the Containment of Covid-19 Infection
Phase 2: Effective from May 4 and for the following two weeks.
Movements within the same Region for reasons of work, health, emergency or visit to relatives will be possible, nevertheless self-declaration is mandatory. The ban on group gathering is still in force. Access to public parks will be allowed by respecting the interpersonal distance.
As far as religious ceremonies are concerned, funerals will be allowed, attended by first and second degree relatives, with the obligation to wear a mask, and limited to a maximum of 15 people.
With regard to food service activities, in addition to home delivery, it will be possible to pick up the products from the venue, in compliance with the safety distance and with the prohibition of consumption inside or nearby.
Manufacturing, construction, real estate brokerage and wholesale trade will resume.
A two-bed intensive care unit within a shipping container, designed by Italian architects Carlo Ratti and Italo Rota, has been built at a hospital in Turin and is being used to treat patients fighting the coronavirus.
The pod, which contains two beds, has been installed at a temporary hospital built within the Officine Grandi Riparazioni complex in central Turin. The first patient was admitted earlier this week on 19 April.
A white collar, remote work strike occurred in Turin at Scai Finance on 23/April.
This may be the first such remote work strike in the history of Italy. I have long observed the history of Labor and have worked remotely throughout much of my career. Striking remotely would have seemed inconceivable just a few months ago. The shockwaves from this crisis will certainly resonate in unexpected ways.
A new study finds some interesting results from the earliest 14-day lockdown in Italy.
On the 21st of February 2020 a resident of the municipality of Vo, a small town near Padua, died of pneumonia due to SARS-CoV-2 infection. This was the first COVID-19 death detected in Italy since the emergence of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province.
Scientists took surveys at two different points in the lockdown.
On the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6%.
On the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2%.
Notably, 43.2% of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic.
It didn't seem to matter if the distribution of infections were symptomatic or asymptomatic - viral load remained the same. In their words, most new infections in the second survey were infected in the community before the lockdown or from asymptomatic infections living in the same household.
Helen Ouyang of the New York Times covered the triage efforts by those in Turin and neighboring provinces. A group of doctors and bioethics experts attempted to draft a reasonable plan:
They include Marco Vergano, a 45-year-old I.C.U. doctor in Turin, in the neighboring province of Piedmont, who is also the chairman of the bioethics group of Italy’s society of intensivists (Siaarti). He’s working back-to-back shifts in the I.C.U., but he jumps online with the six other members of the task force.
[The group] strongly advise[d] against allocating precious resources, like ventilators and beds, on the traditional basis of first-come, first-served, which would reduce the number of lives a hospital could save.
Swift and fierce denunciation of the group and its recommendations follows the document’s release. “You cannot imagine to what extent we have to face harsh criticism,” Vergano says. [He] notes that most of the criticism has come from regions in Italy that have yet to be hit as hard as Lombardy.
The venue, which is commonly known as OGR and was founded by the CRT Foundation, will hold 100 hospital beds for patients recovering from COVID-19 who are in need of semi-intensive therapy, according to La Reppublica. Respirators and other equipment will be brought in for what is expected to be the next four months to relieve crowded intensive-care units at hospitals across Italy.
This seems to be advertorial content for Cisco, but it has some interesting details supplied by the mayor of Turin, Chiara Appendino:
They were able, in 3 weeks, to convert 40% of the City employees to remote work, something that had been evaluated just three months earlier and determined to be impossible. And when it came to setting up the emergency hospitals (the one they showcased had 3,00 beds), using partners, Cisco was able to help set up the networking and communications capabilities in 14 days and 3 hours with seven Cisco employees working with those partners.
Information is key to dealing with this pandemic. Setting up new information infrastructure on the fly is a unique challenge.
It seems masks and sanitizer have once again become available in the city:
What he and his colleagues have been witnessing in the “Isolation Ward” of the hospital over the past few weeks is no less than a nightmare. “We have 30 beds in our ward and all are almost continuously occupied. If a bed gets unoccupied, more often for a death than a discharge, it gets reoccupied within an hour or two,” [Madhu Hemegowda] tells the DH over phone from Turin.
Cocks co-founded The Art Newspaper and is currently in lockdown in Turin. She observes:
There is still one place where you can see real art: the doors of the churches are open, and they count as a place where you may go for “health reasons”.
This lockdown could be seen as the most extraordinary social experiment. Nothing like it has happened before, so I hope someone is keeping notes. Everything public is shut, from schools to bars to shops. No congregating is allowed anywhere for any reason. The church has obeyed the state and no public masses or other liturgies are being celebrated; I am awestruck at the thought that this must be for the first time since Christianity came to the peninsula in the days of Emperor Nero.
Prime Minister Giuseppe Conte announces the closure of all factories and production that is not absolutely essential.
The Military Arrives in Nearby Lombardy
And Chinese medical experts helping Italy deal with the crisis have said the restrictions imposed in Lombardy are "not strict enough."
The government has now agreed that the military can be used to help enforce the lockdown, the president of the Lombardy region, Attilio Fontana, told a news conference on Friday.
"(The request to use the army) has been accepted... and 114 soldiers will be on the ground throughout Lombardy... it is still too little, but it is positive," Fontana said. "Unfortunately we are not seeing a change of trend in the numbers, which are rising."
The soldiers had until now been deployed in the region to ensure general security in the streets.
In the Turin area, where I am based, Internet traffic doubled last week [...] Thierry Breton, the EU Commissioner for Internal Market, said that working from home and streaming put pressure on digital infrastructures.
Consequently, Breton asked Netflix to move to a lower video definition to reduce the bandwidth absorption, even creating a dedicated hashtag, #SwitchToStandard. Netflix, in response, announced it will reduce the bit rate in Europe for a month to reduce bandwidth usage by a fourth.
My sister contacted me, concerned with this excerpt from The Seattle Times: "The State Department on Thursday issued a new alert urging Americans not to travel abroad under any circumstances and to return home if they are already abroad unless they plan to remain overseas." Emphasis mine.
So I called the U.S. Consulate General in Milan today. They forwarded me to an emergency help center that is inundated with calls. I waited on hold for about 25 minutes.
The friendly individual on the other end suggested I enroll in the Smart Traveler Enrollment Program (STEP) today. The purpose of STEP "is to notify U.S. nationals in the event of a disaster, emergency or other crisis, and for evacuation coordination."
The State Department is currently issuing a Global Level 4 Health Advisory – Do Not Travel, which is not a travel ban for American citizens but a strong caution against unnecessary travel. The person on the phone said if I feel safe and have food and water then there is no immanent reason to leave.
Traveling at this point would make me more exposed to COVID-19.
[Nunzia Vallini] explained that the hospital in Brescia (near one of the hardest-hit regions for coronavirus infections) urgently needed valves (in the photo) for an intensive care device and that the supplier could not provide them in a short time. Running out of the valves would have been dramatic and some people might have lost their lives. [...] At the time of writing, 10 patients are accompanied in breathing by a machine that uses a 3D printed valve.
Italy's initial problem was that it simply couldn't identify the person who first brought the virus into the country, known as Patient Zero. That made tracing who that person had come into contact with impossible.
The first confirmed case, or Patient 1, came in a hospital in the northern region of Lombardy. Italian Prime Minister Giuseppe Conte admitted that the hospital there did not follow procedure and inadvertently helped the virus spread.
Comparing 🇮🇹 Italy and 🇰🇷 South Korea
Similar population size
Both confirmed suburban infections around the same time
Both reported an exponential increase of cases in the initial weeks.
Generally speaking, Italy has imposed a more restrictive lockdown than South Korea; South Korea has been testing and tracking more aggressively.
Today, South Korea records a minuscule death rate of less than 1%, according to World Health Organization figures, while Italy's reached over 14% on Friday [13-March], as the country reported another 250 deaths in just 24 hours. More than 1,200 people have died in Italy, which has more than 17,600 cases, officials there say. The global average death rate is currently between 3-4%.
Dewan suggests that testing and tracking might be the difference:
[Korea] has the resources to run about 15,000 diagnostic tests per day and has conducted more than 200,000 tests nationwide. Anyone referred to by a doctor or who has encountered an infected person gets that test for free.
While I am generally concerned about how all this citizen tracking may impact individual privacy in the future, the South Korean Foreign Minister Kang Kyung-wha shared a wonderful sentiment on the value of openness and international interdependence:
The spontaneous concerts and singing were happening all around Italy. The Independent, picked up a similar story in Siena. They highlighted a particularly interesting parallel with China:
Reminiscent of the chants from Wuhan high-rise apartments early in the epidemic there. Stay strong Italy. Praying for you guys.
Northern Italy, especially Lombardy and Piedmont, is the nation's manufacturing hub. Auto production has come to a near-complete halt.
For the second consecutive day very few vehicles are being produced in Italy. Only Ferrari is still building its supercars, but the staff at its plants in Maranello and Modena plants has been reduced to a minimum, the company said. Volkswagen Group's Lamborghini plant has halted production for nearly two weeks. Fiat Chrysler Automobiles' four assembly plants stopped regular production on Wednesday.
The measure provides for the suspension of further categories of services and commercial activities, apart from those involving the sale of food and basic needs, newsstands, tobacconists, pharmacies and parapharmacies. In any case, the interpersonal safety distance of one meter (three feet) must be guaranteed.
On Wednesday, Prime Minister Giuseppe Conte announced the latest step in a process that has progressively turned Italy into a fully quarantined country. [...] People who still go to the office are requested to prove the absolute necessity to do so by signing a certificate that must be submitted and vetted by the police. Transgressors face up to three months in jail and a fine. Going out for physical activity is permitted, provided it’s short and solitary. Schools and universities — which have been shut down since March 4 — will be closed at least until April 3, but the date will likely be extended.
Italy is aggressively testing for the virus, which could help explain why its total confirmed cases are higher than some other countries in Europe. On Tuesday, more than 60,000 tests had been performed, more than twice as many tests as the United Kingdom had done.
In contrast to most other countries, South Korea’s reports of new cases have begun to slow — at least for now. Unlike other countries with major outbreaks, South Korea, with a population of 50 million, has not outright restricted the movement of its citizens and has instead focused on aggressively monitoring for infections. [...] More than 235,000 people have been tested, and health officials carefully track down people who may have symptoms, testing more than 10,000 people each day.
Annalisa Malara tests positive for COVID-19 after being admitted to intensive care on 20-February. His activity between the 14th and the 20th likely spread it to hundreds of people including medical staff at the Codogno hospital.
Annalisa Malara, 38 years old, checks into an emergency room in Codogno in Lombardy with pneumonia. He had the flu since 14-February. ~ la Repubblica
The Importance of Open Science and Computational Notebooks
Open Science in the Pandemic
I pulled in the latest data on March 17th and immediately noticed something was wrong. The employee at the government's Dipartimento della Protezione Civile (Department of Civil Protection) had made a simple error inputting the dates. I cloned the data in the official repository, fixed the information, and requested they pull my (correct) data back into the official repository.
It wasn't a big deal, but it's a reminder of the importance of keeping source data open and in the the public. Thousands of people are auditing the data every day. In the West, our diversity is our strength.
On Computational Notebooks
Why a computational notebook on Nextjournal? Because the internet is more than a facsimile of 20th century technologies. It is larger than shareholder owned "public squares." It is a place for human authorship, not algorithmic curation.
Notebooks make it possible to take raw data and build a narrative with 21st century media. This notebook is re-runnable at any point in the future with the latest data, it is easily shared, and a starting point for conversation. Dr. Craig Spencer said it best: people need clear, concise evidence-based messaging. Notebooks are the perfect format for this effort.
If you'd like to know more about how exponential growth affects the spread of epidemics, this video is a great start. The video will help you understand why it's important to curb the spread of COVID-19 early.